Examining The Association Of Nurse Staffing Levels With Delayed Antibiotic And Insulin Administration: A Mixed Methods Study, Mikie Desyana Rachman

WUSM Theses and Dissertations – All Programs

Background: Recent reports indicated that medication errors contributed to 10% of preventable harm among hospitalized patients with over half occurring during the administration stage. Despite emerging research using EHR data to examine care processes and clinical outcomes, limited studies have integrated objective and subjective nursing staffing measures to evaluate how nursing staffing levels could be associated with delays in care delivery.

Method: A parallel convergent mixed-methods study was conducted in four adult medical-surgical units at a Midwestern Academic Medical Center from January 1 – March 31, 2025. Quantitative data of insulin and IV antibiotic administration records, laboratory results, and nurse …

Neurodiversity Among Nurses: Consequences For Wellbeing And Burnout, Megan Pohlmann

WUSM Theses and Dissertations – All Programs

Background/Introduction – Current research highlights three critical aspects of nurse wellbeing: the subjective personal perspective, multifaceted complexity, and variation across individuals. A particular gap in past research is a lack of understanding of how neurodivergence may impact nurses’ workplace wellbeing. Neurodiversity is the variation in human minds and neurocognitive functioning, and neurodivergence is the divergence from what society would consider the norm. Like wellbeing, it is difficult to capture, recognize, and define, which causes confusion among neurodivergent individuals and employers alike. With up to 20% of individuals displaying neurodivergent traits in the workplace, it is important to recognize that those …

A Quality Improvement Project: The Implementation Of A Nurse Driven Morbidity And Mortality Review In An Emergency Department Setting, Abby Beutel

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Background: Morbidity and mortality reviews/conferences (MMR) are a mandatory curriculum requirement for medical residency programs throughout the United States to identify and reduce medical errors. Only within the past few decades have hospital organizations expanded MMRs to multidisciplinary teams to include medical professionals who are rendering care at the bedside more than medical providers.

Purpose: This quality improvement (QI) project focuses on the application of a nurse drive MMR amongst emergency department (ED) nurses in a community hospital in Northern Bergen County, New Jersey. This ED nurse driven MMR measured the ED nurse’s knowledge and confidence levels as it …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Confederate Women In The Field Of Nursing And Their Impact On Southern Women’S Roles In Society, Laura Leigh L. Prater

Theses

During the Civil War, Confederate women had the opportunity to go to work as nurses. The majority of these women had never been allowed to take on roles beyond the domestic sphere in antebellum society.  Despite most of these women having limited medical training, they developed an expertise in nursing, extraordinary organization skills and gained respect for their achievements.  Their achievements proved that women were able to do far more than many in the South believed prior to the war.  This paper will show how the demands of war opened doors of greater opportunity for women in the South for …

Beyond Cough Drops And Band-Aids: An Interpretive Phenomenological Study Of Certified School Nurses’ Professional Scope And Enacted Roles In Pk–12 Settings, Brandy Gershon

Electronic Theses and Dissertations

This qualitative dissertation explored the underutilization of certified school nurses (CSNs) in PK–12 educational settings across urban, suburban, and rural school districts in western Pennsylvania. Despite their advanced preparation and wide-ranging scope of practice, school nurses are often limited to providing episodic care, including first aid, medication administration, and treatment of minor injuries. This limited use reflects a significant misalignment with their professional scope of practice, which encompasses chronic disease management, health education, mental health support, care coordination, and leadership in public health. Guided by role theory (Biddle, 1986), this study examined how school nurses perceived and interpreted their professional …

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

The Role Of Nurses In Robotic-Assisted Surgery, Tehya Wiedemeier, Gretchen Faith Grambow, Ella Froehlich, Whitney Anna Holmes

Epsilon Sigma at-Large Research Conference

The research examines the evolving role of nurses in robotic-assisted surgery. As the technology advances, the nursing role is expanding beyond the traditional responsibilities. The method of literature review for this study was completed through deductive content analysis based off three data bases called Science Direct, PubMed (Medline), and Scopus. Current research is working towards trying to bring educational awareness to the role of nurses within the robotic surgery environment and what new skills they will have to acquire.  For nurses to successfully fit into the role of assisting within robotic surgery, they will need to obtain a higher level …

New Graduate Nurse Retention Strategies Toolkit For Managers And Leadership, Taryn Ryan

Student Scholarly Projects

Practice Problem:

Nurse retention has been a persistent issue for over a decade, with increasing turnover among new graduate nurses. Many new nurses leave the profession due to inadequate preparation for clinical roles and responsibilities.

PICOT:

The PICOT question that guided this project was: For nurse managers and leaders supporting new graduate nurses (P), how does the development of a best-practice retention toolkit (I), compared to existing retention practices (C), guide evidence-based strategies to improve nurse retention (O)?

Evidence:

Evidence indicates that new graduate nurses often feel insufficiently prepared for patient care responsibilities, compromising patient safety (Haddad et al., 2023; …

Collaboration Between People Admitted To Acute Mental Health Units, Their Family Members And Nurses In The Detection Of Mental State Changes And Recovery: A Qualitative Systematic Review, Karen Foster, Coventry, Yvonne Middlewick, Lindsay Smith, Beverley Ewens

Research outputs 2022 to 2026

Mental health nurses can engage with people with mental health challenges and their families due to their presence on acute mental health units. This presence helps to facilitate recovery-focused care within a physically and emotionally safe environment. Mental health care should be person-centred, individualised, and include wherever possible family and other people in the person's support network. The objective of this systematic review was to explore the existing qualitative literature that describes experiences of collaboration between people with lived experience of mental health challenges, their family members, and nurses in relation to changes in mental state during an admission to …

Optimizing Healthcare Utilization: Distinguishing Between Emergency And Urgent Care, Madilyn Calkins, Molly Dupar, Wintana Gherie, Marcin Janczak, Angela Lee, Lena Zhang

Nursing Leadership in Community Engagement Projects

Optimizing Healthcare Utilization: Distinguishing Between Emergency and Urgent Care

Over the past two months, our group of six nursing students worked with a local transitional housing program for families. Per the facility report, a large portion of the program’s current residents are immigrants and have had little to no exposure to the American healthcare system and their options for care. The issue we targeted for our project is the increased number of 911 calls and emergency room (ER) visits for non-emergent healthcare concerns by our target population. By creating education materials on self-triaging, ER vs. Urgent Care services, and how …

Becoming A Nurse: A Lifelong Journey Beyond The Transition To Professional Practice-An Analytical Discursive Paper, Seung A. Park, Eckert, Rebecca Sharp, Judy Duchscher, Micah D.J. Peters

Research outputs 2022 to 2026

Aim: To reconceptualise becoming a nurse as a lifelong developmental journey that extends beyond the traditional focus on new graduate transition, and to inform policies and practices supporting recruitment, retention and career sustainability. Background: The global nursing shortage persists, exacerbated by high attrition rates among new graduates and an aging workforce. While existing literature predominantly examines the transition from student to professional practice, we propose that ‘becoming a nurse’ begins earlier and extends beyond clinical roles into retirement. Design: An analytical discursive paper. Data Sources: Key theoretical frameworks (Schlossberg's Transition Model, Kennedy's Integrated Transition Model, Benner's Novice-to-Expert framework and Duchscher's …

A Competency Based Pressure Injury Management Program, Madina Qadir

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project aims to implement a simulation-based wound management program to address critical gaps in nurses’ competencies for managing pressure injuries (PIs). The initiative seeks to enhance nurses’ knowledge, clinical skills, and confidence in wound assessment and advanced therapies, fostering evidence-based practice and consistent care delivery. Effective PI management is vital for improving patient outcomes, reducing healing times, and minimizing complications. Yet, nursing education and competency gaps often lead to inconsistent care and increased healthcare costs. A structured competency-based pressure injury management (CB PIM) program integrates evidence-based didactic lectures and interactive simulation-based skills stations to cover essential topics, including wound …

Reduction In Patient Falls: A Quality Improvement Project, Jotis J. Lee

Doctor of Nursing Practice Projects

Patient falls remain one of the most frequent adverse events in hospital settings, leading to injury, prolonged hospital stays, and increased healthcare costs. The identified problem was high fall rates at a specialty hospital. The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to evaluate the effectiveness of an evidence-based (EB) educational intervention, using the Fall TIPS (Tailoring Interventions for Patient Safety) toolkit, in improving direct care nursing staff’s knowledge, confidence, and perceived ability to implement fall prevention strategies for high-risk patients. The aim was to improve the nursing staff’s knowledge, confidence, and perceived ability …

Factors Influencing The Provision Of Human Milk Feeding Support For Preterm Infants In Neonatal Intensive Care Units In China: A Qualitative Study Of Neonatal Nurses’ Perspectives, Wenjie Guo, Haiyan Zhang, Li Wang, Fang Huang, Dongmei Ma, Maggie Zgambo, Sanmei Chen, Yan Wu, Yanmei Bu, Yoko Shimpuku

Research outputs 2022 to 2026

Background: Human milk feeding is crucial for the survival and development of preterm infants, yet their human milk feeding rates at Neonatal Intensive Care Units (NICUs) discharge remain lower than those of healthy newborns. Effective support is essential for improving breast milk feeding outcomes, but remains challenging for NICU nurses. Therefore, this study aimed to examine factors that influence NICU nurses in providing human milk feeding support, including the challenges they face and their needs. Methods: This study employed a qualitative descriptive design. Using maximum variation and purposive sampling, 19 nurses in the NICU were recruited. Between August and September …

Supporting Discharge Preparation For Children With Medical Complexity: A Scoping Review, Emily Moore, Mia Waldron, Darlene Acorda, Cara Gallegos, Barbie Giambra, Stacee M. Lerret, Christine R. Platt, Danielle A. Sarik, Zara Sajwani-Merchant, Nesibe Sumeyye Kutahyalioglu, Pamela Gampetro, Susan Groshong, Marianne Weiss, Teri L. Hernandez, Sandra Staveski

College of Nursing Faculty Research and Publications

Background

The transition from hospital to home is a critical period for children with medical complexity (CMC) and their caregivers, often associated with increased risks and stress. Both registered nurses and advanced practice nurses play a pivotal role in facilitating this transition through discharge preparation, including planning, coordination, and teaching. However, best practices for optimizing discharge processes for CMC remain unclear. The need for a comprehensive understanding of hospital discharge during this crucial time is apparent as adverse events following discharge are common and are often attributed to insufficient preparation and communication. This scoping review aims to identify key nursing …

Living With Disability After Spinal Cord Injury: A Grounded Theory Methodology, Diaa K. Abd Ali

Al-Ameed Journal for Medical Research and Health Sciences

Study Design: A Grounded Theory Methodology is employed to investigate the study phenomenon. the entire study started from Jan. 15^th. 2021 to March, 1^st. 2022.

Aim: The study is conducted to explore the concepts that shape the experience of living with disability among patients with spinal cord injury, and to formulating a grounded theory regarding nursing care for patients with spinal cord injuries.

Setting: The study is conducted in Ibn Alkuf Hospital for Spinal Cord Injuries, Baghdad, Iraq.

Methods: A non-probability purposive sampling technique was used to select (12) patients with chronic (more than 5 years) …

Strategies For Sustainable Recruitment, Retention, And Engagement In State Nurse Organization, Carolyn E. Hunter Layne

Doctor of Nursing Practice Projects

Many state nurse organizations are experiencing minimal and stagnant membership, which hinders involvement in policy advocacy, professional development, and workforce stability in healthcare. Policy changes are needed to offer state nurse organization memberships under the umbrella of a single organization that operates multiple medical clinics and employs at least one nurse. This research examined strategic policy interventions designed to increase membership within a state-level nursing organization. The problem is that a minimum number of state-licensed nurses are choosing to join professional nursing organizations, and membership models must be identified. The literature review drew on research from various scholarly sources specific …

Implementing A Multi-Faceted Approach To Reduce Falls And Enhance Safety In Psychiatric Patients While Improving Nurses Perception While Improving Nurses Perception Of Fall Risk Identification, Shanika King

Doctor of Nursing Practice Final Project Abstract

Purpose: The goal of this quality improvement project was to decrease falls in inpatient psychiatric units by at least 5% within six months, utilizing a multifaceted approach while increasing nurses' ability to identify patients at risk for falls. This project incorporated fall risk assessment, staff education, visual identifiers, and debriefings. Nurse confidence was measured post-intervention using a Likert scale survey.

Background: Psychiatric fall rates range from 13 to 25 per 1,000 hospital days, compared to 3 to 4 in general hospitals. These rates highlight the importance of tailored interventions. This project was completed in an inpatient psychiatric facility in …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Hospital Organizations’ Obligation To Promote Spiritual Well-Being Among Nurses: Development Of A Normative Ethical Argument, Michael Jordan

Electronic Theses and Dissertations

This dissertation presents an innovative strategy to promote the support of nurses' spirituality within hospital organizations. By focusing on the spiritual well-being of nurses by hospital organizations, with a natural extension into nursing schools, the approach aims to enhance nurse’s ability to protect their own spirituality, provide comprehensive spiritual care to patients, and increase nurse moral resilience. By investing in nurses' spirituality and spiritual growth, hospitals can potentially increase job satisfaction among nursing staff, improve patient care outcomes, and create a more holistic healing environment for both nurses and patients. As the nursing shortage continues and the number of nurses …

Associations Between Tiktok Use And Undergraduate Nursing Professional Identity, Parker M. Watts

Honors Theses

Background. The global surge in social media usage prompts extensive research into its links with nursing professional identity. College-aged individuals who are in nursing school or are going to be in nursing school in the future must navigate their professional identity as they face heightened susceptibility to subjective opinions about the career of a nurse due to their frequent engagement with social media platforms. Among these platforms is that of TikTok, a platform of which has rapidly gained traction, especially among younger demographics. TikTok remains relatively underexplored in terms of its impact on nursing professional identity. This study seeks to …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Recurrent Urinary Tract Infections In The Urgent Care Clinic, Stephanie Krol

Evidence-Based Practice Project Reports

Nearly 60% of women will suffer from a urinary tract infection (UTI) in their lifetime, with 20- 40% of them suffering from multiple (Anger et al., 2022). The primary purpose of this evidence-based project was to implement a multi-modal intervention to improve identification of women who suffer from recurrent urinary tract infections (rUTIs) and to assist in the prevention and treatment of future UTIs. Additionally, the project aimed to increase the number of referrals to urology for better management of these patients. This project was implemented at an Urgent Care Clinic (UCC) in northwest Indiana. Eligible participants who presented with …